精神分裂症患者就业的临床和认知相关性：马来西亚的一项横断面研究。
Clinical and cognitive correlates of employment among patients with schizophrenia: a cross-sectional study in Malaysia.
机构信息
Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
出版信息
Int J Ment Health Syst. 2011 May 30;5:14. doi: 10.1186/1752-4458-5-14.
BACKGROUND
Gainful employment is one major area of functioning which is becoming an important goal in psychiatric rehabilitation of patients with schizophrenia. Studies in western countries are pointing to evidence that certain sociodemographic and clinical factors may contribute to employment outcomes in this group of people. However, the area is still largely unexplored in Malaysia. The aim of this study was to examine the sociodemographic, clinical and cognitive correlates of employment status among patients with Schizophrenia.
METHODS
This was a cross-sectional study. All participants who fulfilled the requirements of the study according to the inclusion and exclusion criteria were enrolled. Study instruments included a demographic data questionnaire, Positive and Negative Symptom Scale (PANSS), Trail Making Tests, Rey's Auditory Verbal Learning Test (RAVLT) and Digit Span. Bivariate analyses were done using chi-square for categorical data and t-test for continuous data and multiple logistic regression analysis was done to identify predictors of employment status.
RESULTS
A total of 95 participants who fulfilled the inclusion criteria were enrolled into the study. Among the sociodemographic, clinical and cognitive variables studied marital status, educational level, mean scores of negative symptoms, Digit Span and RAVLT and Trail Making Tests were found to show significant association with employment status on bivariate analyses. However, when entered into a logistic regression model, only cognitive variables ie. Trail A and B, Digit Span and RAVLT were significant predictors of employment status.
CONCLUSIONS
The results from this study support the role of cognitive function, particularly, attention, working memory and executive functioning on attaining and maintaining employment in persons with schizophrenia as measured by the RAVLT, Digit Span and Trail Making Tests. These findings may act as preliminary evidence suggesting the importance of integrating cognitive rehabilitation in the psychosocial rehabilitation program for patients with schizophrenia in Malaysia.
背景
有酬工作是精神分裂症患者精神康复的主要领域之一，且正成为一个重要目标。西方国家的研究表明，某些社会人口学和临床因素可能对这组人群的就业结果产生影响。然而，该领域在马来西亚仍在很大程度上尚未得到探索。本研究旨在探讨精神分裂症患者的社会人口学、临床和认知因素与就业状况的相关性。
方法
这是一项横断面研究。所有符合研究纳入和排除标准的参与者均被纳入研究。研究工具包括人口统计学数据问卷、阳性和阴性症状量表（PANSS）、连线测试 A 和 B、瑞文氏连续推理测验（RAVLT）和数字跨度。使用卡方检验进行分类数据的二变量分析，使用 t 检验进行连续数据的二变量分析，并进行多元逻辑回归分析以确定就业状况的预测因素。
结果
共纳入了符合纳入标准的 95 名参与者。在研究的社会人口学、临床和认知变量中，婚姻状况、教育程度、阴性症状的平均分、数字跨度和 RAVLT 以及连线测试 A 和 B 的得分与就业状况在二变量分析中显示出显著相关性。然而，当进入逻辑回归模型时，只有认知变量，即连线测试 A 和 B、数字跨度和 RAVLT，是就业状况的显著预测因素。
结论
本研究结果支持认知功能，特别是注意力、工作记忆和执行功能，对精神分裂症患者获得和维持工作的作用，这可通过瑞文氏连续推理测验、数字跨度和连线测试来衡量。这些发现可能初步证明，在马来西亚，将认知康复纳入精神分裂症患者的心理社会康复计划的重要性。
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